Comparison of segmental wall motion in EGG-gated myocardial scintigraphy and transthoracic echocardiography.

EGG-gated myocardial scintigraphy (Gspect) is a recent method of assessing myocardial perfusion, left ventricular ejection fraction and regional wall motion in a single investigation. It reduces the time required for the eval uation of coronary patients by radionucleide cardiology. Many reports have validated the measurement of the left ventricular ejection fraction compare d with other methods. However, there are fewer series reporting the results of regional wall motion. The authors compared segmental wall motion by Gspect after injecting Thalli um or Mibi and by transthoracic echocardiography in 47 patients or 423 myoc ardial segments. The concordance of score (normal, hypokinetic, akinetic, d yskinetic) was 75% (Kappa = 0.538). If analysis was limited to a normal-abn ormal differentiation (binary analysis) it increased to 83%. When perfusion was taken into consideration, it was 81% (normal perfusion), 63% (mild hyp operfusion) and 70% (moderate and severe hypoperfusion). This concordance i mproved in binary analysis respectively to 85, 74 and 86% respectively. Whe n the typs of segment was taken into consideration, concordance varied from 57 to 100%. The concordances were 74% for Thallium and 78% for Mibi scinti graphy, improving to 82% and 85% respectively in binary analysis. Thus, analysis of LV regional wall motion by Gspect is comparable to transt horacic echocardiography. This result, completed by measurement of LV eject ion fraction and of myocardial perfusion, provides a method of evaluation o f coronary patients in a single investigation.